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Prescription practices of diagnostic imaging in dementia: a survey of 47 Alzheimer's Centres in Northern Italy
Author(s) -
Riello R.,
Albini C.,
Galluzzi S.,
Pasqualetti P.,
Frisoni G. B.
Publication year - 2003
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.893
Subject(s) - dementia , medical prescription , alzheimer's disease , medicine , psychiatry , gerontology , psychology , pathology , disease , pharmacology
Background To date, there are no data at the national or European level on the prescription practices of imaging (CT, MR, and SPET) in the diagnosis of cognitively impaired elderly patients. Methods We addressed prescription practices of diagnostic imaging in 47 Alzheimer's Centres in Northern Italy, with an ad‐hoc questionnaire. Results The use of imaging in new cases was relatively intensive: 62% of the Alzheimer's Centres prescribed CT to more than 95% of cases, 24% prescribed MR to more than 33% of cases, and 33% prescribed SPET to more than 5% of cases. A minority of Alzheimer's Centres ( n = 3, 6%) prescribed imaging to less than 100% of new cases. The association between onsite scanner availability and frequency of prescription increased from CT (Odds ratio (OR) = 1.8) through MR (OR = 2.4) to SPET (OR = 4.6), although only the latter was significant (95% confidence interval (CI) 1.2–17.7, p = 0.003). Patient‐related factors (age, severity of cognitive impairment, and clinical suspicion of cerebrovascular disease) influenced prescription of structural imaging in 30–53% of Alzheimer's Centres and organizational factors (onsite scanner availability, and waiting list) in a similar proportion (32 and 43% respectively). Conclusions Organizational factors play a relevant role in the prescription of imaging exams in patients with cognitive impairment and, at least for CT, the perceived diagnostic added value is rather low, suggesting a high degree of uncertainty in the clinical use of imaging techniques. Copyright © 2003 John Wiley & Sons, Ltd.